GRANT R GOLUB MD (Credential# 153187) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
GRANT R GOLUB MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0005566. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 25 Knight St, Wethersfield, CT 06109. The current status is lapsed.
| Licensee Name | GRANT R GOLUB MD |
| Credential ID | 153187 |
| Credential Number | CSP.0005566 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
25 Knight St Wethersfield CT 06109 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 539757 | 1.010641 | Physician/Surgeon | 1961-08-18 | 2017-10-01 - 2018-09-30 | INACTIVE |
| Street Address | 25 KNIGHT ST |
| City | WETHERSFIELD |
| State | CT |
| Zip Code | 06109 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan E Dimauro | 330 Ridge Rd, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Mary Boccacio | 174 Longvue Drive, Wethersfield, CT 06109 | Esthetician | ~ |
| Steven C Hine | 294 Hang Dog Ln, Wethersfield, CT 06109 | Architect | 2020-08-01 ~ 2021-07-31 |
| Karolina Monika Fitrzyk | 41 Mountain Laurel, Wethersfield, CT 06109 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Matthew R Dobos | 33 Oxford St, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Samantha Grabbe | 17 Rockland St, Wethersfield, CT 06109 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Judith M Martz | 307 Nott Street, Wethersfield, CT 06109 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Ups Store (the) | 1077 Silas Deane Hwy, Wethersfield, CT 06109 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Amber H Washington | 103 Parkview Drive, Wethersfield, CT 06109 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Kathleen A Mullady · Brancati | 75 Dale Rd, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06109 | |||
| City | WETHERSFIELD |
| Zip Code | 06109 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WETHERSFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stacey H Golub Dvm | 172 Hog Hill Road, East Hampton, CT 06424 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Philip G Ong | 267 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| James M Grant Md | Po Box 775, Londonderry, VT 05148 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Ning Guo | 267 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2013-05-16 ~ 2015-02-28 |
| Abiola J Grant | 28 Ash Cir, Trumbull, CT 06611-5276 | Controlled Substance Registration for Practitioner | 2020-01-22 ~ 2021-02-28 |
| Pei-tsung Liu | 267 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2010-07-23 ~ 2011-02-28 |
| Edwin Jin Su Lee | 297 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2017-08-11 ~ 2019-02-28 |
| Jun Yi Lai | 267 Grant Street, Bridgeport, CT 06610-0120 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Yue Shen | 267 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Jay A Zaslow Md | 658 Grant Rd, N Salem, NY 10560 | Controlled Substance Registration for Practitioner | 2003-02-13 ~ 2004-02-28 |
Please comment or provide details below to improve the information on GRANT R GOLUB MD.
| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).